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Incidence of macular edema following single versus 4 session pattern scanning laser panretinal photocoagulation in diabetic retinopathy
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Edité par CCSD ; Wiley-Blackwell -
Purpose: The purpose of this study was to investigate a change in macular thickness 9 months after single versus 4 sessions of panretinal photocoagulation (PRP) performed with Pattern Scanning Laser (PSL) in diabetic patients and to make a medico-economic assessment. Methods: This prospective, multicenter, randomized trial enrolled patients in 2 arms: single session PRP (group A) and 4 session PRP (group B) between October 2011 and October 2013. Patients had non proliferative severe diabetic retinopathy or proliferative non complicated diabetic retinopathy. The primary endpoint was the difference in macular central retinal thickness (CRT) using spectral domain optical coherence tomography (SD-OCT) at 9 months. CRT with SD-OCT, ETDRS visual acuity (VA), pain with Visual Analogic Scale (VAS), were recorded at baseline, 7 days, 1, 3, 6, and 9 months. A medico-economic assessment was also performed. Results: 26 eyes of 26 patients were included. On inclusion, the median CRT was 258 [240-294] µm in group A and 282 [261-292] µm in group B (p=0.06), the median VA was 84 [76-88] letters in group A and 83 [75-90] letters in group B (p=0.94). At M9, the median CRT was 281 [245-322] µm in group A and 301[278-313] µm in group B (p=0.34). At M9, the median VA was 84 [70-91] letters in group A and 85 [74-85] letters in group B (0.58). The median VAS value was 3.5 [2.0-5.0] in in group A and 3.5 [1.0-7.0] for all sessions in group B. The medico-economic assessment was in favor of the single session protocol. Conclusion: Single session PSL-PRP seems to be a possible, well tolerated protocol for the treatment of diabetic retinopathy.
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